O câncer de mama é um dos maiores problemas de saúde para a população feminina, devendo ser encarado como um importante problema de saúde pública. A ultrassonografia é considerada o método mais efetivo na complementação de diagnóstico de doenças mamárias, porém a forma de aquisição desse método diagnóstico degrada a imagem sob diversas formas, destacando-se o ruído speckle, o qual deixa a imagem com aspecto granulado, dificultando assim a separabilidade entre os objetos da cena. Este trabalho apresenta uma técnica automática para segmentação de nódulos mamários em imagens de ultrassom. O algoritmo permite a extração das bordas nodulares, permitindo assim a obtenção de parâmetros clínicos utilizados no diagnóstico mamário. Todo o processo se baseia em três etapas: minimização do ruído speckle, aumento de contraste da imagem e por fim, a segmentação. A técnica utilizada para minimização do ruído speckle baseia-se na Wavelet da família Symlet; técnicas para aumento de contraste na imagem são aplicadas para a segmentação. A partir daí, é aplicado o algoritmo de segmentação Asterisco, originalmente proposto para a detecção de microcalcificações em mamografias por raios X, e que mostrou também eficiência para os objetivos deste trabalho. A técnica Asterisco em conjunto com as de pré-processamento (minimização de ruído e aumento de contraste) produziu taxa de sensibilidade na detecção de nódulos da ordem de 90%. Em relação à qualidade da segmentação, a técnica apresentada neste trabalho também se mostrou satisfatória, superior às técnicas testadas, de acordo com a análise feita pelo cálculo de coeficientes de correlação de Pearson. É possível concluir que o sistema desenvolvido neste trabalho pode constituir-se numa ferramenta eficaz de segmentação de nódulos mamários em imagens de ultrassom, auxiliando o conjunto de informações disponíveis para um classificador automático em esquemas CAD em mamografia. / Breast cancer is one of the main health problems of the female population and should be faced as an important public health care issue. The ultrasound scanning is considered the most effective in complementary method of breast diagnosis. Nevertheless, the acquisition format of this sort degrades the images in various ways, being the speckle noise of noticeably influence once it leaves the image with grainy aspect. Therefore, the separability between objects of the scene is hindered. This work presents an automatic technique of ultrasound image segmentation of breast lumps. The algorithm allows the extraction of the nodular edges permitting the clinical parameters to be obtained for the breast diagnosis. All the process is based on three steps: speckle noise minimization, image contrast intensification and finally the segmentation. The technique used on the speckle noise minimization is based on the Wavelet transform of the Symlet family; image contrast intensifications are applied for the segmentation. Thereafter the algorithm of segmentation Asterisco is applied, which is originally proposed to detect micro calcifications in X-ray mammography, and has also shown efficiency regarding the goals of the present work. The Asterisco technique along with the pre processing techniques (noise minimizing and contrast intensification) produced sensitivity rate in nodule detection by 90%. With regard to the segmentation quality, the presented technique has also proved to be satisfactory as it has superior quality to the ones tested according to the analysis made by the Pearson\'s correlation coefficients calculation. Thus, it is possible to conclude that the system, which has been developed in this work, can constitute an efficient breast lumps segmentation tool so as to aid the set of available information to an automatic classifier in mammography CAD schemes.

In Boston Massachusetts, Black and White women aged 50-74, experience limited access to breast cancer screening. The purpose of this quantitative study was to investigate whether there is a correlation between breast cancer screening access to personal healthcare providers among Black and White women, aged 50- 74, in Boston, MA. The study focused on whether there was a correlation between breast cancer screening access and socioeconomic status among women, and whether a correlation existed between breast cancer screening and their educational levels. The study was informed by the health belief psychological framework. The study consisted of secondary data from the Behavioral Risk Factor Surveillance System with a sample size of n =1815, 18 years and above. Exclusion criteria consisted of adults under age 40, women above age 74 diagnosed with cancer, and had mastectomies previously. A chi square test examined the relationship between the independent and dependent variables. The key results showed a significant relation between race and access to healthcare providers. The study also found a significant relationship between low income levels and limited access. The study results portrayed a nonsignificant relationship between breast cancer screening and educational levels among black and white women. The results concluded that access to healthcare providers was significant among the races as well as their income levels. The study contributes to social change by promoting awareness through education of individuals, communities, organizations and the society at large.

Breast cancer is a global public health issue, and even though the incidence and mortality rates for this disease have declined, a substantial gap in mortality rates between U.S. women of color and European American women remains. Strategies have been initiated to decrease this gap, but they have not addressed the special needs of women of color residing in the United States, who tend to be diagnosed only after they have developed late-stage breast cancer. The purpose of this phenomenological study was to understand the perceptions and behaviors of 20 first-generation Caribbean and South American-born women of color living in Atlanta, Georgia, related to breast cancer awareness, screening, treatment, and follow-up care. Qualitative data analysis was used to identify themes that included, but were not limited to, the role of genes in breast cancer, lifestyle influences and risk of breast cancer, environmental factors, positive perceptions of foods and their impact on breast health, the role of culture on health care decisions, fear of harm from radiation exposure, familial relationships, understanding why they sought screening and/or treatment, and familial health histories and increased risk of breast cancer. The participants' cues to take action were influenced by knowledge, health insurance coverage, confidence, educational attainment, age, income, family support, and self-motivation. Culture, race, or ethnicity had little to no effect on whether the women received breast cancer screening or mammography. The findings could facilitate social change by educating Caribbean and South American women of color in the United States about breast cancer and the need for screening, to reduce the incidence of breast cancer and the mortality rates among the target population and improving their quality of life.

Mammography screenings are performed regularly on women in order to detect early signs of breast cancer, which is the most common form of cancer. During an exam, X-ray images (called mammograms) are taken from two different angles and reviewed by a radiologist. If they find a suspicious lesion in one of the views, they confirm it by finding the corresponding region in the other view. Finding the corresponding region is a non-trivial task, due to the different image projections of the breast and different angles of compression needed during the exam. This thesis explores the possibility of using deep learning, a data-driven approach, to solve the corresponding regions problem. Specifically, a convolutional neural network (CNN) called U-net is developed and trained on scanned mammograms, and evaluated on both scanned and digital mammograms. A model based method called the arc model is developed for comparison. Results show that the best U-net produced better results than the arc model on all evaluated metrics, and succeeded in finding the corresponding area 83.9% of times, compared to 72.6%. Generalization to digital images was excellent, achieving an even higher score of 87.6%, compared to 83.5% for the arc model.

The goal in medical x-ray imaging is to obtain the image quality requiredfor a given detection task, while ensuring that the patient dose is kept as lowas reasonably achievable. The two most common strategies for dose reductionare: optimizing incident x-ray beams and utilizing energy informationof transmitted beams with new detector techniques (spectral imaging). Inthis thesis, dose optimization schemes were investigated in two x-ray imagingsystems: digital mammography and computed tomography (CT). In digital mammography, the usefulness of anti-scatter grids was investigatedas a function of breast thickness with varying geometries and experimentalconditions. The general conclusion is that keeping the grid is optimalfor breasts thicker than 5 cm, whereas the dose can be reduced without a gridfor thinner breasts. A photon-counting silicon-strip detector developed for spectral mammographywas characterized using synchrotron radiation. Energy resolution, ΔE/Ein, was measured to vary between 0.11-0.23 in the energy range 15-40 keV, which is better than the energy resolution of 0.12-0.35 measured inthe state-of-the-art photon-counting mammography system. Pulse pileup hasshown little effect on energy resolution. In CT, the performance of a segmented silicon-strip detector developedfor spectral CT was evaluated and a theoretical comparison was made withthe state-of-the-art CT detector for some clinically relevant imaging tasks.The results indicate that the proposed photon-counting silicon CT detector issuperior to the state-of-the-art CT detector, especially for high-contrast andhigh-resolution imaging tasks. The beam quality was optimized for the proposed photon-counting spectralCT detector in two head imaging cases: non-enhanced imaging and Kedgeimaging. For non-enhanced imaging, a 120-kVp spectrum filtered by 2half value layer (HVL) copper (Z = 29) provides the best performance. Wheniodine is used in K-edge imaging, the optimal filter is 2 HVL iodine (Z = 53)and the optimal kVps are 60-75 kVp. In the case of gadolinium imaging, theradiation dose can be minimized at 120 kVp filtered by 2 HVL thulium (Z =69). / <p>QC 20160401</p>

This research presents a framework for enhancing and analyzing time-sequenced mammographic images for detection of cancerous tissue, specifically designed to assist radiologists and physicians with the detection of breast cancer. By using computer aided diagnosis (CAD) systems as a tool to help in the detection of breast cancer in computed tomography (CT) mammography images, previous CT mammography images will enhance the interpretation of the next series of images. The first stage of this dissertation applies image subtraction to images from the same patient over time. Image types are defined as temporal subtraction, dual-energy subtraction, and Digital Database for Screening Mammography (DDSM). Image enhancement begins by applying image registration and subtraction using Matlab 2012a registration for temporal images and dual-energy subtraction for dual-energy images. DDSM images require no registration or subtraction as they are used for baseline analysis. The image data are from three different sources and all images had been annotated by radiologists for each image type using an image mask to identify malignant and benign. The second stage involved the examination of four different thresholding techniques. The amplitude thresholding method manipulates objects and backgrounds in such a way that object and background pixels have grey levels grouped into two dominant and different modes. In these cases, it was possible to extract the objects from the background using a threshold that separates the modes. The local thresholding introduced posed no restrictions on region shape or size, because it maximized edge features by thresholding local regions separately. The overall histogram analysis showed minima and maxima of the image and provided four feature types--mean, variance, skewness, and kurtosis. K-means clustering provided sequential splitting, initially performing dynamic splits. These dynamic splits were then further split into smaller, more variant regions until the regions of interest were isolated. Regional-growing methods used recursive splitting to partition the image top-down by using the average brightness of a region. Each thresholding method was applied to each of the three image types. In the final stage, the training set and test set were derived by applying the four thresholding methods on each of the three image types. This was accomplished by running Matlab 2012a grey-level, co-occurrence matrix (GLCM) and utilizing 21 target feature types, which were obtained from the Matlab function texture features. An additional four feature types were obtained from the state of the histogram-based features types. These 25 feature types were applied to each of the two classifications malignant and benign. WEKA 3.6.10 was used along with classifier J48 and cross-validation 10 fold to find the precision, recall, and f-measure values. Best results were obtained from these two combinations: temporal subtraction with amplitude thresholding, and temporal subtraction with regional-growing thresholding. To summarize, the researcher's contribution was to assess the effectiveness of various thresholding methods in the context of a three-stage approach, to help radiologists find cancerous tissue lesions in CT and MRI mammography images.

Le risque potentiel de cancer induit par les irradiations mammographiques est sujet de santé publique majeur, d’intérêt médical et scientifique. Le but de ce travail a été de quantifier les cassures double-brin (CDB) de l’ADN en conditions exactes d’irradiations mammographiques. Cette quantification a été effectuée sur des cellules épithéliales mammaires non transformées issues de biopsies échoguidées en tissu sain en utilisant l’immunofluorescence de la protéine histone H2AX phosphorylée (γH2AX), avant, 10 min et 24 h après irradiation . Deux populations de patientes ont été incluses dans l’étude 19 sans antécédent familial de cancer du sein et/ou de l’ovaire (faible risque, FR) et 11 à haut risque identifié par le généticien avec ou sans mutation (haut risque, HR). En effet, les gènes mutés suppresseurs de tumeurs (BRCA1, BRCA2, CHK2, ATM, p53, PTEN) sont également impliqués dans la signalisation et/ou réparation des CDB. Spontanément, les patientes HR ont montré significativement plus de CDB spontanées que les LR. Trois effets radiobiologiques majeurs ont été mis en évidence : 1) Un effet de la dose, plus important chez les HR ; 2) Une augmentation significative du nombre de foci γH2AX entre 10 min et 24 h après irradiation ; 3) Un effet de répétition de dose, plus marqué chez les HR. Ces constatations devraient conduire à la ré-évaluation des séquences de dépistages mammographiques dans les populations où le bénéfice en terme de mortalité n’a pas été prouvé, comme dans la tranche d’âge des 40-49 ans et dans la surveillance des patientes où sont recommandées de façon annuelle IRM et mammographie dès l’âge de 30 ans ou 35 ans, les hauts risques et les femmes aux antécédents d’irradiation thoracique dans l’enfance, l’adolescence ou jeune adulte. Une seule incidence mammographique en dépistage pourrait être préconisée en dépistage dans l’attente de travaux radiobiologiques complémentaires évaluant la carcinogenèse éventuelle des irradiations mammographiques / The potential risk of cancer induced by radiation mammography is a major public health issue, medical and scientific interest. The purpose of this study was to quantify the double-strand break (DSB) DNA in exact terms of mammographic radiation. This quantification was performed on untransformed mammary epithelial cells from ultrasound-guided biopsies in healthy tissue using fluorescent protein phosphorylated histone H2AX (γH2AX) before, 10 min and 24 h after irradiation. Two patient populations were included in the study : 19 with no family history of breast cancer and/or ovarian cancer (low risk, LR) and 11 high-risk identified by the geneticist with or without mutation (high risk, HR). Indeed, mutated tumor suppressor genes (BRCA1, BRCA2, CHK2, ATM, p53, PTEN) are also involved in signaling and/or repair of DSBs. Spontaneously, patients showed significantly higher HR of DSBs that spontaneous LR. Three major radiobiological effects were highlighted : 1) A dose low effect, higher in HR; 2) A significant increase in the number of γH2AX foci from 10 min to 24 h after irradiation; 3) An effect of repeated doses more pronounced in HR. These findings should lead to re-evaluate mammographics procedures in screnning in populations where the benefit in term of mortality has not been proved, as women with high familial risk, in the age of group of 40-49 years, and in women treated with chest radiation for childhood, adolescent, or young adult cancer. A single mammographic view could be indicated. Further works assessing the possible carcinogenesis effects of mammographic irradiations will be necessary

Introdução: O cãncer de mama com fenótipo triplo negativo é definido como um tumor com receptor de estrógno e progesterona negativos e human epidermal growth factor receptor 2 (HER2) negativo. Desde sua primeira descrição, alguns artigos tentaram descrever sua aparência radiológica, sem nenhum consenso. Estas pacientes podem ter características clínicas e imaginológicos distintas. Seria interessante verificar se as características radiológicas desses tumores são as mesmas relatadas no câncer de mama familiar e com mutação do gene BRCA1, muitas vezes associados a esse subtipo tumoral. Estas características que muitas vezes simulariam doenças benignas poderiam atrasar o diagnóstico precoce, refletindo a necessidade de seu conhecimento radiológico na prática. Neste contexto, este estudo poderia auxiliar no reconhecimento precoce de lesões mamárias e alertar o médico para solicitar uma biópsia, consequentemente, resultando num diagnóstico precoce. Objetivo: O principal objetivo desse estudo foi avaliar as características radiológicas dos carcinomas ductais invasivos de mama nos seguintes métodos de diagnóstico por imagem: mamografia, ultrassonografia e ressonância magnética, utilizando a padronização do American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS®), comparando os casos de carcinomas com fenótipo triplo negativo dividindo-os em não basal e basal com o uso da citoqueratina 5. Pacientes e Métodos: Revisamos os arquivos de imagens do Instituto de Radiologia (InRad) da Faculdade de Medicina da Universidade de São Paulo (FMUSP) e do Instituto do Câncer do Estado de São Paulo (ICESP), durante o período da coleta de dados, que envolveu 12 anos. Trata-se de estudo descritivo observacional, realizado após a aprovação do comitê de ética. Foram avaliadas 6.952 resultados de biópsias cirúrgicas ou percutâneas por agulha grossa de mama e após a verificação do material radiológico e histológico, chegamos ao resultado de 106 casos. Todas as reações imunohistoquímicas foram lidas por dois patologistas e os exames radiológicos foram avaliados por dois radiologistas, todos especialistas em doenças da mama em suas respectivas áreas. Resultados: A maioria das pacientes incluídas foram mulheres brancas, com idade entre 24-81 anos. Na mamografia, a principal lesão observada foi o nódulo (74,7%), com margem espiculada (36,9%) e forma oval (60,0%), seguido pela assimetria focal (12,6%), lesões ocultas (9,2%) e assimetria global (3,4%). Nenhuma lesão principal se manifestou como microcalcificações. Os tumores avaliados pela ressonância magnética se manifestaram principalmente como lesão nodular (92,0%), com forma irregular (60,0%), margem irregular (44%) e realce heterogêneo (56,0%). A curva tipo 3 (91,7%) foi comumente observada. O isosinal em T2 foi mais freqüentemente observado (52,2%). A ausência de áreas císticas foi observada na maioria das lesões (47,8%). Todos os tumores avaliados pelo ultrassom foram vistos, principalmente como nódulos (98,1%), hipoecoicos (90,3%), com forma irregular (61,2%), margem mal definida (34,7%) e o reforço acústico posterior (32,0%) e halo ecogênico (46,6%) foram comumente observados. Conclusão: Não foram encontradas associações estatisticamente significativas das características tumorais e demográficas com os subtipos de tumores (p > 0,05) na mamografia, ultrassom e ressonância magnética. Houve correlaçãos inversa entre a idade e o tamanho do tumor. Apenas no USG os linfonodos positivos apresentaram em média estatisticamente maior tamanho tumoral associado que os linfonodos negativos (p=0,045). Em nossa série, observamos que embora algumas características tenham sido mais frequentes, não houveram características que mostraram diferença estatisticamente significante entre os subtipos. Assim, não se pode atribuir qualquer característica específica que possa melhorar a acurácia diagnóstica / Introduction: Breast cancer with triple negative phenotype is defined as estrogen receptor negative tumor, progesterone receptor negative and human epidermal growth factor receptor 2 (HER2) negative. Since its first description, some articles have tried to describe its radiological appearance, with no consensus. These patients can have adverse clinical and imaging characteristics. It would be interesting to check if the radiological characteristics of these tumors are the same related in the familiar breast cancer and associated to the mutation of gene BRCA1, many times associated to this tumor subtype. These characteristics, that many times would simulate benign diseases, could delay the early diagnosis, reflecting the need of its radiological knowledge in practice. In this context, this study could help in the early recognition of breast lesions and alert the doctor to require a biopsy, consequently resulting in an early diagnosis. Objectives: The main objective of this study was to evaluate the radiological characteristics of breast invasive ductal breast carcinomas with triple negative invasive phenotype in the following diagnostic image methods: mammography, ultrasound and magnetic resonance, using the American College of Radiology Breast Imaging Reporting and Data System (ACR BIRADS ®) criteria, divided in basal and not basal subtypes with the use of cytokeratin 5. Patients and Methods: We\'ve reviewed the images from the Radiology Institute (InRad) from Faculty of Medicine of the University of São Paulo (FMUSP) and from the Cancer Institute of São Paulo (ICESP), during the period of data collecting, which took 12 years. This aims to be an observational descriptive study, realized after the Ethic Committee\'s approval. 6952 results of breast surgical or percutaneous needle biopsies were evaluated and after checking the radiological and histological material, we came to the result of 106 cases. All the immunohistochemical reactions were read by two pathologists and the radiological exams were evaluated by two radiologists, all specialists in breast illnesses in their respective areas. Results: Most patients included were white women, aging between 24-81 years old. In the mammography, the main lesion observed was the nodule (74,7%), spiculated margin (36,9%) and oval shape (60%), followed by focal asymmetry (12,6%), hidden lesions (9,2%) and global asymmetry (3,4%). No main lesion showed microcalcifications. The tumors evaluated by magnetic resonance imaging showed mainly as nodule (92,0%), irregular shaped (60,0%), irregular margin (44,0%) and heterogeneous enhancement (56,0%). The curve type 3 (91,7%) was generally observed. The isosignal in T2 was most frequently observed (52,2%). The absence of cystic areas was observed in most of the lesions (47,8%). The tumors evaluated by the ultrasound were seen principally as nodules (98,1%), hypoechoic (90,3%), irregular shaped (61,2%), ill-defined margin (34,7%) and with posterior acoustic enhancement (32,0%) and echogenic halo (46,6%). Conclusion: There were no statistically significant associations of tumor and demographic characteristics with tumor subtypes (p > 0.05) in mammography, ultrasound and magnetic resonance imaging. There were inverse correlations between the age and the size of the tumor. Only in USG positive lymph nodes had on average larger tumor size with a statistically significant result that the negative lymph nodes (p = 0,045). In our series, we\'ve observed that, although some characteristics have been more frequent, there were no characteristics which showed difference statistically significant among the subtypes. Therefore, we can not attribute any specific characteristic that can improve the diagnostic accuracy

O objetivo deste trabalho é apresentar um novo método para a remoção do ruído Poisson em imagens de mamografia digital adquiridas com baixa dosagem de radiação. Sabe-se que a mamografia por raios X é o exame mais eficiente para a detecção precoce do câncer de mama, aumentando consideravelmente as chances de cura da doença. No entanto, a radiação absorvida pela paciente durante o exame ainda é um problema a ser tratado. Estudos indicam que a exposição à radiação pode induzir a formação do câncer em algumas mulheres radiografadas. Apesar desse número ser significativamente baixo em relação ao número de mulheres que são salvas pelo exame, existe a necessidade do desenvolvimento de meios que viabilizem a diminuição da dose de radiação empregada. No entanto, uma redução na dose de radiação piora a qualidade da imagem pela diminuição da relação sinal-ruído, prejudicando o diagnóstico médico e a detecção precoce da doença. Nesse sentido, a proposta deste trabalho é apresentar um método para a filtragem do ruído Poisson que é adicionado às das imagens mamográficas quando adquiridas com baixa dosagem de radiação, fazendo com que ela apresente qualidade equivalente àquela adquirida com a dose padrão de radiação. O algoritmo proposto foi desenvolvido baseado em adaptações de algoritmos bem estabelecidos na literatura, como a filtragem no domínio Wavelet, aqui usando o Shrink-thresholding (WTST), e o Block-matching and 3D Filtering (BM3D). Os resultados obtidos com imagens mamográficas adquiridas com phantom e também imagens clínicas, mostraram que o método proposto é capaz de filtrar o ruído adicional incorporado nas imagens sem perda aparente de informação. / The aim of this work is to present a novel method for removing the Poisson noise in digital mammography images acquired with reduced radiation dose. It is known that the X-ray mammography is the most effective exam for early detection of breast cancer, greatly increasing the chances of healing the disease. However, the radiation absorbed by the patient during the exam is still a problem to be treated. Some studies showed that mammography can induce breast cancer in a few women. Although this number is significantly low compared to the number of women who are saved by the exam, it is important to develop methods to enable the reduction of the radiation dose used in the exam. However, dose reduction led to a decrease in image quality by means of the signal to noise ratio, impairing medical diagnosis and the early detection of the disease. In this sense, the purpose of this study is to propose a new method to reduce Poisson noise in mammographic images acquired with low radiation dose, in order to achive the same quality as those acquired with the standard dose. The method is based on well established algorithms in the literature as the filtering in Wavelet domain, here using Shrink-thresholding (WTST) and the Block-matching and 3D Filtering (BM3D). Results using phantom and clinical images showed that the proposed algorithm is capable of filtering the additional noise in images without apparent loss of information.

Neste projeto foi desenvolvido um método computacional para verificação da melhor combinação tela intensificadora - filme para exames mamográficos através do estudo de suas características sensitométricas. O software, desenvolvido em ambiente Delphi para windows, apresenta na tela do microcomputador a imagem a ser obtida para cada tipo de combinação tela intensificadora - filme, utilizando imagens de \"Phantoms\" e de mamas reais. Em razão da ampla quantidade de fatores que influenciam a imagem mamográfica final, tais como magnificação, característica dos filmes e telas intensificadoras e condições da processadora, o método proposto pode proporcionar uma ampla avaliação da qualidade dos sistemas de imagem mamográfica de uma forma simples, rápida e automática, através de procedimentos de simulação computacional. A simulação investigou a influência que um determinado sistema de registro exerce sobre a qualidade da imagem, possibilitando conhecer previamente a imagem final a ser obtida com diferentes equipamentos e sistemas de registro. Dentre os sistemas investigados, três filmes (Kodak Min R 2000, Fuji UM MA-HC e Fuji ADM) e duas telas intensificadoras (Kodak Min R 2000 e Fuji AD Mammo Fine), aquele que apresentou melhores resultados, com melhor qualidade de imagens e menor exposição à paciente foi o de tela Min R 2000 com filme Min R 2000 da Kodak. / The present research has as main objective the development of a computational method for verification of the best combination screen-film for mammographic examinations through the study of its sensitometric characteristics. The software interface was developed in Delphi for windows and display the image to be gotten for each type of combination screen-film, using images of Phantoms and real breasts. Because several factors influence the final mammographic image, such as magnification, characteristic of the films and screens and conditions of the processing, the method can provide an ample evaluation of the quality of the systems of mammographic image of a simple, fast and automatic form, through procedures of computational simulation. The simulation investigates the influence of a register system on the quality of the image, making it possible to know the final image previously to be gotten with different equipment and register systems. Three films (Kodak Min R 2000, Fuji UM MA-HC and Fuji ADM) and two screens (Kodak Min R 2000 and Fuji AD Mammo Fine) was avaliable and the screen Min R 2000 with film Min R 2000 was the best result with less exposure.